Cardiologist FAQ

Robert Schiller is the first patient to receive Radial STEMI at CFCVI. He shares his expereince.

A heart attack is in some ways a complex situation in terms of the entire body. But the cause is very simple. The cause of a heart attack is a clot forming in a narrowing in one of the arteries to the heart and the clot obstructs the vessel and prevents blood supply to the heart muscle. As a result of that a part of the heart begins to die. There has been tremendous progress in preventing damage to the heart and preventing that part of the heart muscle from dying.

Lifestyle changes after a heart attack are vital. Adequately changing lifestyle can definitely prevent a second heart attack. The only factor that puts a person at risk for a heart attack is our family history that we cannot change. Everything else can be changed. / We can lose weight and thereby reduce our blood sugars and blood pressure. We could quit smoking, we could take medications faithfully to lower cholesterol, take blood thinners, and we could exercise regularly.

Let's breakdown what exactly cholesterol results mean, when you have your blood work drawn, you always want to make your blood fasting at a minimum of 12 hours. With those lab results you will have goals according to the American Heart Association for some range of numbers. Let's go over some of those numbers. Your total cholesterol range should be under 180 and Triglycerides under 150. Your HDL or good cholesterol s for men should be greater than 40. And for women it should be greater than 50. The bad cholesterol or LDL this is the cholesterol this bad cholesterol component that builds the blockage in our heart arteries and other vascular parts of our bodies such as the leg arteries, the brain arteries. This number needs to be less that 100 as an ideal range. Now once you have diabetes diagnosed or you have a documented blockage in your artery that number needs to be under 70.

CAD stands for Coronary Artery Disease and it's a process whereby the arteries that supply the heart get diseased. The commonest cause of CAD is a process called atherosclerosis which is a disposition of plaque cholesterol plaque at the coronary arteries. This plaque can clog the arteries and prevent flow of blood to the arteries, this plaque can also cause heart attacks.

The most important thing for blood pressure control especially if you do not want to take any medication is why you have high blood pressure. Is it because you are overweight, lack of exercise, eat a lot of salt which turns out to be the main reason why, once you define why you have hypertension then you need to address that. / In the case that you cannot just do it by yourself, by losing weight, doing exercise regularly, controlling your salt intake, definitely blood pressure medication is our number one choice because we need to control the blood pressure before you get a stroke or any other problems.

Plaque that produces coronary artery disease, arises in the vessel in the artery, but it's related to certain risk factors. Factors like high cholesterol, diabetes, high blood pressure, smoking.

It is very important to know the difference between the signs and symptoms of a heart attack, chest pains and abdominal pains to make sure we are not either missing the symptoms for a gallbladder attack for a heart attack or a heart attack for a gallbladder attack. / So there are different ways that we can differentiate those, that is why we do a stress test when signs and symptoms are non-specific and we are not so sure. And the patient has enough risk factors being diabetic, smoker, high blood pressure, obesity. Then we tend to pursue more towards heart disease and do a specialized stress test with additional nuclear a to see if it is additional blockage in the arteries that is causing the symptoms. / If we are not convinced and we think it is abdominal pain we can always offer ultra sound and surgical consultation and find out what it is.

TEE (trans-esophageal echocardiogram) is very valuable when it comes to looking for clots in the heart, looking at the valves of the heart to make sure that they are not infected and don't have a condition called endocarditis. Looking for leaking heart valves or heart valves that don't open properly and that are stopped up. / Diet is extremely important, and includes weight loss, restriction of animal fats, consumption of sufficient amounts of fiber and restriction of amounts of refined carbohydrates.

TEE (trans-esophageal echocardiogram) what we prefer to in the hospital as TEE is a process whereby we make a patient swallow a probe and the probe takes breathtaking pictures of the heart from the esophagus, from the food pipe the esophagus sits right behind the heart and the probe is very to the cardiac structures so we see surprising detail and TEE is invaluable when it comes to diagnosing certain conditions.